The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients : synthesis of evidence and expert opinion and its translation into practice

The original publication is available at http://cre.sagepub.com/content/early/2011/04/15/0269215510397677

Includes bibliography

Article

Objective: To facilitate knowledge synthesis and implementation of evidence supporting early physical
activity and mobilization of adult patients in the intensive care unit and its translation into practice, we
developed an evidence-based clinical management algorithm.
Methods: Twenty-eight draft algorithm statements extracted from the extant literature by the
primary research team were verified and rated by scientist clinicians (n¼7) in an electronic three
round Delphi process. Algorithm statements which reached a priori defined consensus – semi-interquartile
range <0.5 – were collated into the algorithm.
Results: The draft algorithm statements were edited and six additional statements were formulated. The
34 statements related to assessment and treatment were grouped into three categories. Category A
included statements for unconscious critically ill patients; Category B included statements for stable and
cooperative critically ill patients, and Category C included statements related to stable patients with
prolonged critical illness. While panellists reached consensus on the ratings of 94% (32/34) of the algorithm
statements, only 50% (17/34) of the statements were rated essential.